Capitol Hill Report: Advocacy Key to Changes at Home, Abroad

August 6, 2012

Congress left town for the August recess with an agreement to fund government for the next six months to avoid a shutdown before the elections. But it failed to address any of the other big issues that demand attention before the end of the year including fixing the nearly 30–percent cut called for by the Medicare Sustainable Growth Rate (SGR) formula or Sequestration. Congress will return for two weeks in September before it again recesses to campaign for the November elections.

Get Involved During the August Recess

Congress will be out of session until after Labor Day, which means your members will be in their district offices to meet with constituents, engage local press, and be seen in their communities. Now is easiest time to make your case to your lawmakers. Take advantage of this opportunity to educate your senators and representatives about the value of neurologists in your community and the significant challenges facing the profession now and in the future.

The best way to find opportunities taking place in your area is to contact your local congressional office. If you need any assistance or have questions, please contact AAN Congressional Affairs Representative Derek Brandt at dbrandt@aan.com.

Capitol Hill Report Vacation Notice

Congress will be out until September 10 and so will the Capitol Hill Report. With little news on the congressional front, I asked AAN Government Relations Committee (GRC) Chair Elaine C. Jones, MD, FAAN, of Rhode Island to describe her recent experience volunteering in Haiti. The GRC is responsible for setting the federal advocacy priorities for the Academy.

One Neurologist’s Haiti Experience

By Elaine C. Jones, MD, FAAN

Elaine Jones, MD, FAAN with Haitian PT, Jocelyn Francois.

I started my advocacy journey in 2003 by attending the first AAN Palatucci Advocacy Leadership Forum. Since then, I have had great opportunities and experiences developing AAN legislative policy, meeting with federal and state political leaders, and taking part in reforming health care in the United States.

Recently, the connections I have made through my work with the Academy gave me the opportunity to spend a week in Haiti doing charity health care. Work in an impoverished country may seem far from the legislative work I do in the US, but it also provided a new perspective on advocacy for me.

As we struggle with health care reform in this country, it is useful to see how systems work in other parts of the world.

In a country like Haiti, with severely limited resources, everyone is forced to think more about cost/benefit and quality. In the US, we are having the same discussions but for different reasons. When there is no access to an MRI in the entire country, physicians must rely on detailed history and examination skills. As I provided care, I found myself recalling basic training of anatomy and thinking about pathophysiology. It was a relief to not have to worry about getting paid, checking the right boxes on forms, or testing to protect against lawsuits. I was able to start to focus on the patient again.

That was the positive side.

I spent most of my time working in the spinal cord injury unit with a Haitian physician, an American PT, and a Haitian therapist. One of the biggest needs there now is teaching. They have the staffing and basic equipment but they need to know how to do neurological exams, take detailed histories, interpret test results, and put everything together.

But once word gets out that there is a neurologist available, patients come from everywhere. Motor vehicle accidents, gunshot wounds from robberies, and medical issues related to poor nutrition, poor sanitation, and lack of clean water were common. Patients came from towns as far as two hours away for evaluations. Many had progressive neurological symptoms but had never had a neurological exam.

Spinal Cord Injury Unit at Hospital Bernard Mevs.

With my advocacy training, I was constantly thinking about how to make the system better. I don’t expect to change centuries of government dysfunction in Haiti. But my hope is I can help set into motion some programs that will improve the lives of Haitian neurology patients. Simply organizing regular neurology volunteers to take one week out of their year could provide monthly, consistent neurologic care to those who otherwise have none. This would only take twelve volunteers. This is advocacy work on a whole different level.

Upon returning to the US, I realized the possibilities that exist in our country. Health care reform is here to stay and, although change is always painful, I am more grateful than ever for what we have. I realize the importance of making sure we continue to provide high–quality, and yes, low–cost health care to our neurology patients, no matter what country they live in.

I have truly appreciated the opportunities that the AAN has given me to advocate on behalf of US neurologists and after my experience in Haiti I am looking even more forward to helping make our system work for AAN members and the patients we treat, whether they are in the US or anywhere in the world.